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Purpose: The International Society of Pharmacoepidemiology (ISPE) in collaboration with the Latin America Drug Utilization Research Group (LatAm DURG), the Medicines Utilization Research in Africa (MURIA) group, and the Uppsala Mo...
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Purpose: The International Society of Pharmacoepidemiology (ISPE) in collaboration with the Latin America Drug Utilization Research Group (LatAm DURG), the Medicines Utilization Research in Africa (MURIA) group, and the Uppsala Monitoring Center, is leading an initiative to understand challenges to drug utilization research (DUR) in the Latin American (LatAm) and African regions with the goal of communicating results and proposing solutions to these challenges in four scientific publications. The purpose of this first manuscript is to identify the main challenges associated with DUR in the LatAm region. Methods: Drug utilization (DU) researchers in the LatAm region voluntarily participated in multiple discussions, contributed with local data and reviewed successive drafts and the final manuscript. Additionally, we carried out a literature review to identify the most relevant publications related to DU studies from the LatAm region. Results: Multiple challenges were identified in the LatAm region for DUR including socioeconomic inequality, access to medical care, complexity of the healthcare system, limited investment in research and development, limited institutional and organization resources, language barriers, limited health education and literacy. Further, there is limited use of local DUR data by decision makers particularly in the identification of emerging health needs coming from social and demographic transitions. Conclusions: The LatAm region faces challenges to DUR which are inherent in the healthcare and political systems, and potential solutions should target changes to the system.
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The field of “Pharmacoepidemiology/Drug Utilization” research has been analysed by studying published research articles under the medical subject headings (MeSH terms) “Pharmacoepidemiology”, “Drug Utilization” and “Drug Ut...
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The field of “Pharmacoepidemiology/Drug Utilization” research has been analysed by studying published research articles under the medical subject headings (MeSH terms) “Pharmacoepidemiology”, “Drug Utilization” and “Drug Utilization Review”. There were 1822 articles published, and stored in Medline, during the 32-month period between 1 January 2001 and 31 August 2003; these papers might represent a field of research, due to the similarity of MeSH terms used for coding and the set of journals in which the articles were published. A total of 457 articles, representing 25% of all articles in the field, were published in 14 different journals, and 50% of all articles (948) were collected in only 64 different journals. The two main journals publishing research in “Pharmacoepidemiology/Drug Utilization” are Pharmacoepidemiol Drug Saf and the Eur J Clin Pharmacol. These two publications are the official journals of the three main societies in the field and are at least partially focused on this subject, with 45.7% of all articles in Pharmacoepidemiol Drug Saf and 11.1% of all articles in Eur J Clin Pharmacol included under the studied MeSH terms; other journals only occasionally publish papers in this line of research. These two journals are the leaders in pharmacoepidemiology and drug utilization research, having impact factors (IFs) in 2002/2003 above (1.955/1.972 for EJCP) and a bit below (1.092/1.257 for PDS) the middle of the ranking of publications, according to the IF, in the “Pharmacology and Pharmacy” list of the Science Citation Index (SCI).
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Purpose: The aim of the study was to identify trends in utilization of antiepileptic drugs (AEDs) over time in a nation-wide population in Israel.
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Background: Drug Utilization Evaluation studies are crucial to the health care system's efforts to rationalize patient care practices like prescribing, dispensing, and usage of medications. In pharmaco-epidemiological studies, DUE...
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Background: Drug Utilization Evaluation studies are crucial to the health care system's efforts to rationalize patient care practices like prescribing, dispensing, and usage of medications. In pharmaco-epidemiological studies, DUE plays a crucial role. This study was carried out to assess the prescription and medication use patterns in expectant mothers, comprehend the significance of different classes of drugs used during pregnancy, and categorize them according to US FDA categorization.Methodology: 118 pregnant women's case files were obtained from the medical record department who were admitted in a time span of 3 months, and a retrospective observational study design was chosen to analyze the cases using MS Excel software. Each case file was analyzed for the demographic variables, various categories of drugs prescribed during pregnancy; co-morbidities if present, various drugs under each category; and categorization of prescribed drugs according to US FDA pregnancy category guidelines.Result: The study revealed that the most common co-morbidity was found to be gestational diabetes mellitus, followed by the thyroid. The most commonly prescribed drugs were vitamins and minerals (26.o6%) followed by antibiotics (13.73%). Levocetirizine (35.38%) was the most commonly prescribed anti-histamine. Category B (59.77%) drugs were found to be the most widely prescribed.Conclusion: The present study showed that vitamins and mineral supplements were the most commonly prescribed drugs during pregnancy, while anti-pyretic drugs were used less. Use of category B drugs must be reduced, while category X drugs should be completely avoided. Along with Vitamin D, the use of folic acid should also be increased.
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Abstract Objectives The aim of this study was to examine the characteristics of patients, physicians, and medical facilities, and their association with prescriptions that do not include metformin as the initial oral antidiabetic ...
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Abstract Objectives The aim of this study was to examine the characteristics of patients, physicians, and medical facilities, and their association with prescriptions that do not include metformin as the initial oral antidiabetic agent. Study design Observational, cross-sectional study. Methods Patients with incident type 2 diabetes between January 1, 2006, and December 31, 2010, were identified from the Taiwan National Insurance Research Database. We describe trends in the initial prescription of antidiabetic medications that do not contain metformin during the study period. A multivariable logistic model and a multilevel linear model were used in the analysis of factors at a range of levels (patient, physician, and medical facility), which may be associated with the selection of oral antidiabetic drugs. Results During the study period, the proportion of prescriptions that did not include metformin declined from 43.8% to 26.2%. Male patients were more likely to obtain non-metformin prescriptions (adjusted odds ratio [OR]: 1.15; 95% confidence interval [CI]: 1.08–1.23), and the likelihood that a patient would be prescribed a non-metformin prescription increased with age. Physicians aged ≥35 years and those with specialties other than endocrinology tended to prescribe non-metformin prescriptions. Metformin was less commonly prescribed in for-profit?hospitals (adjusted OR: 1.34, 95% CI: 1.11–1.61) and hospitals in smaller cities (adjusted OR: 1.28, 95% CI: 1.05–1.57) and rural areas (adjusted OR: 1.83, 95% CI: 1.32–2.54). Conclusions Disparities continue to exist in clinical practice with regard to the treatment of diabetes. These inequalities appear to be linked to a variety of factors related to patients, physicians, and medical facilities. Further study will be required to understand the effects of continuing medical education in enhancing adherence to clinical guidelines. Highlights ? Prescriptions not containing metformin as the initial agent keep declining. ? Disparities exist in initial prescriptions for patients with incident diabetes. ? Features of patient, physician, and medical facility determine drug prescriptions.
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In the treatment of hypertension, physicians’ attitudes and practice patterns are receiving increased attention as contributors to poor blood pressure (BP) control. Thus, current use of antihypertensive drugs in primary care was ...
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In the treatment of hypertension, physicians’ attitudes and practice patterns are receiving increased attention as contributors to poor blood pressure (BP) control. Thus, current use of antihypertensive drugs in primary care was analyzed and the association with selected physician and patient characteristics was assessed.
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Purpose Drug utilization studies have proven to be an effective tool in the evaluation of rational drug use in different health care systems, including oncology. The drug utilization studies were used in many institutes to ensure ...
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Purpose Drug utilization studies have proven to be an effective tool in the evaluation of rational drug use in different health care systems, including oncology. The drug utilization studies were used in many institutes to ensure the safe, effective and appropriate use of drugs being prescribed. The main aim of this study was to assess the utilization pattern of anticancer drugs in breast cancer patients. Method A retrospective cross-sectional observational study was carried out at King Saud University Medical City (KSUMC) for 1?year from January 2016 to December 2016. All female patients diagnosed with breast cancer during this year were included in the study. Results A total of 101 patients were included in this study. Most patients received an average of three anticancer drugs. The most commonly prescribed medication was fluorouracil, epirubicin, and cyclophosphamide (FEC) regimen, which was used in 81% of patients. Combinations of FEC?+?docetaxel and FEC?+?docetaxel?+?trastuzumab were received by43% and 23% of patients, respectively. Docetaxel was the most commonly used drug in neoadjuvant setting, whereas letrozole and trastuzumab were prescribed more frequently in hormonal and targeted therapies, respectively. The total drug expenditure on anticancer therapy was approximately 3.8 million Saudi Riyals (S.R), with adjuvant therapy constituting over half of the total spending. In neoadjuvant settings, the spending cost for hormonal therapy was the highest. The condition of most breast cancer patients was improved during the study period, whereas only 29% of the included patients progressed. Conclusion FEC was the most common regimen used in this study, consistent with the National Comprehensive Cancer Network (NCCN) guideline recommendation. Our results indicated that adherence to a clinical guideline and recommended medication regimens improved patient outcomes. Our finding indicate how analyzing drug utilization pattern could benefit institutions in managing inventory and efficiently using health care resources.
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What is known and objectiveThere are few studies examining both drug-drug and drug-disease interactions in older adults. Therefore, the objective of this study was to describe the prevalence of potential drug-drug and drug-disease...
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What is known and objectiveThere are few studies examining both drug-drug and drug-disease interactions in older adults. Therefore, the objective of this study was to describe the prevalence of potential drug-drug and drug-disease interactions and associated factors in community-dwelling older adults.
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Background: Glaucoma is a chronic, gradual and progressive eye disorder characterized by visual loss and involving the typical changes in optic nerves and associated structures. Currently, the mainstay treatment lies in the reduct...
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Background: Glaucoma is a chronic, gradual and progressive eye disorder characterized by visual loss and involving the typical changes in optic nerves and associated structures. Currently, the mainstay treatment lies in the reduction of intraocular pressure (IOP) involving the usage of two or three medications concurrently. However, prescription pattern of antiglaucoma drugs remains largely unstudied so far. Therefore, there is a dire need of drug utilization studies to ensure rational prescribing for better treatment outcomes. Aim: This study was conducted to assess the prescription pattern in glaucoma patients to encourage rational use of drugs. Materials and Methods: The pertinent data of confirmed glaucoma patients were entered in a predesigned case record form (CRF) including patient demographic details, type of glaucoma, number of drug prescribed, drug dosage and dosage formulation with prior patient consent, and finally, the data were analyzed using Microsoft Excel. Results: A total of 247 glaucoma patients were recorded in the study. The mean SD number of drugs per prescription was 2.18 (1.68). Monotherapy was prescribed to 72 (29.15%) patients, and the most common monotherapy prescribed was timolol, whereas in fixed-dose combinations (FDCs), brimonidine and timolol FDCs were most commonly encountered. Furthermore, prescriptions consisting of generic drugs only and prescribed as per the National List of Essential Medicines (NLEM) were 48 (19.43%) and 41 (16.59%), respectively. Conclusion: This study showed the judicious use of medications in tune with principles of rational drug use in our center, and the rationale practices can be extended to the peripheral centers of the country for better drug utilization.
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